Pharmaceutical Care Plan - Cap

Ventilator - associated pneumonia (VAP) is the second most common hospital acquired infection (HAI) and is associated with high morbidity and mortality rates for ventilated patients in intensive care units (Bingham, Ashley, Jong, & Swift, 2010). The VAP increases patients’ mortality rates, length of stay and hospital costs (Hiner, Kasuya, Cottingham, & Whitney, 2010). The VAP is the leading causes of death due to nosocomial infections and the

At around 0953 on June 8, 2017, I contacted Mrs. BV the director of the geriatric social worker who is in charge of older adults home, long-term and nursing facilities visitations in the community. She has few different ways of collecting her data, one of them is by interviewing residents face-to-face in their homes. She stated that this method has been efficient because she gets honest information from the residents by speaking to them directly. She also reviews long-term and nursing facilities including the city health department data to compare with her assessment findings. After evaluating all the data, community-acquired pneumonia was identified as the priority health problem due to the lack of knowledge on signs and symptoms of the disease.

Among critically-ill patients in acute care facilities, pneumonia is one of the most frequently acquired hospital infections (Curtin, 2011). Ventilator-associated pneumonia (VAP) is the second most common healthcare-associated infection (HAI) in the United States and it is responsible for approximately 25% of infections that occur in intensive care units (Sedwick et al., 2012). VAP is defined as a hospital-acquired lung infection that develops in patients who are intubated and receiving mechanical ventilation at the time of or within 48 hours prior to the onset of infection (Sedwick et al., 2012; Gianakis et al., 2015). The definition of VAP, provided by the Centers for Disease Control and Prevention (CDC), encompasses a combination of radiological,

File, T. (2017). Treatment of community-acquired pneumonia in adults in the outpatient setting. Retrieved from https://www.uptodate.com/contents/treatment-of-community-acquired-pneumonia-in-adults-in-the-outpatient-setting?source=search_result&search=treating%20community-acquired%20pneumonia%20in%20adults&selectedTitle=2~150#H11

Although declining, inappropriate antibiotic prescribing continues to be a problem, especially the use of broad-spectrum antibiotics for infections of predominantly viral etiology, increasing risk for developing drug-resistant infection complications (Aspinall, Good, Metlay, Mor, & Fine, 2008; Garau & Dagan, 2003). Few interventions have been effective in moderating antibiotic overuse for acute URTIs (Legare et al., 2012). Emphasis on infection control alone is inadequate to address the rise of resistant infections. Judicious prescribing is the

Ventilator Associated Pneumonia (VAP) is the second most common infection that patients develop while in the hospital and the leading cause of death due to hospital acquired infections (Augustyn, 2007). Hospital acquired infections are also known as nosocomial infections. VAP usually happens when patients are on mechanical ventilation (the ventilator) for over 48 hours. VAP is costly because it increases the hospital length of stay, often times in the Intensive Care Units (ICU). Patients are often on the ventilator and are receiving antibiotics to treat the pneumonia. This paper will show that

The authors of Current Opinion in Pulmonary Medicine state that “Ventilator-associated pneumonia (VAP), a subset of HAP that occurs in mechanically ventilated patients more than 48 h after tracheal intubation” The type of ventilator that is needed to treat patients is called a mechanical ventilator. For these ventilators, a tube has to be inserted down the person’s throat thus causing more bacterial to get inside the patient’s body. Conclusion While most may think that hospitals are an environment for patients to return to their healthy state, hospitals can also be an environment where it deters them from healing. Hospital-acquired illnesses kill many each year and is due to reason of neglect or misuse of equipment.

Ventilator-associated pneumonia is defined as pneumonia occurring more than 48 hours after patients have been intubated and received mechanical ventilation. Diagnosing VAP requires a high clinical suspicion combined with bedside-examination, radiographic-examination, and microbiologic analysis of respiratory secretions. Aggressive surveillance is vital in under-standing local factors leading to VAP and the microbiologic milieu of a given unit. Judicious antibiotic usage is essential, as resistant organisms continue to plague intensive care units and critically ill patients. Simple nursing and respiratory therapy interventions for prevention should be adopted. (para.2)

Clostridium difficile infection , the dependent variable is operationally defined as hospitalized patient who experience over two unusual loose/liquid stool in 24 hours with no apparent etiology and has tested positive for toxin assay-performed by polymerase chain reaction (PCR) or has had pseudomembranes visualized on sigmoidoscopy, histopathology, or colonoscopy (Brown, Fisman, Moineddin, & Daneman, 2014).

Healthcare-associated infections (HAIs) have been found to be number ten on the list of the leading causes of death in the United States. The Centers for Disease Control and Prevention (CDC) have estimated that in a year HAIs cause 1.7 million infections, 99,000 associated deaths, all of which cost approximately $30 billion (Masud & Vykoukal, 2011). HAIs are the kind of infections that are acquired by patients during the course of receiving treatment for other conditions. HAIs in most cases affect those patients who are receiving medical surgical treatments or those with reduced host defenses as a result of age, underlying diseases, or even other conditions. For many years those patients that were affected by these infections were reported

Healthcare-associated infections (HAIs) affect patients in a hospital, GP clinic, nursing home, patient’s in home after discharge or any other healthcare facility (NHMRC, 2010). These infection are not usually present at the time of hospital admission (WHO, 2009). Healthcare associated infections or nosocomial infections such as UTI, pneumonia, gastroenteritis among them healthcare associated pneumonia (HCAP) is one of the most common, significant and controllable issues today specially in immunocompromised patients. The impact of this infection includes increased risks of patient morbidity and mortality, extended hospital stay, additional suffering, decrease quality of life and also extra cost to treat the infection which burden both for patient

Community acquired pneumonia (CAP) is and has been a major health problem here in the U.S. This disease mostly affects young children and the elderly 65. Streptococcus pneumoniae is the most common bacteria causing pneumonia, this bacterium has over 90 different stereotypes and is extremely hard to pin point the different mutating strains. Pneumonia is contracted from inhalation of droplets; any one coughing or sneezing around your area and carrying the virus can pass it along to you fairly easy. Pneumonia is an upper respiratory infection that causes the lungs to be inflamed and fill the alveoli (air sacs) with fluids causing lack of oxygen to the red blood cells. The most common test for S. pneumoniae is the optichin sensitivity with an optichin

Combinations of various criteria to establish a diagnosis in patients with VAP have been suggested and validated (Table 1). The National Nosocomial Infection Surveillance (NNIS) system was developed in the 1970s by the Centers for Disease Control as a tool to describe the epidemiology of hospital-acquired infections and to produce aggregated rates of infection suitable for inter-hospital comparison, but was never compared to pathological results. The NNIS system was compared to bronchoalveolar lavage (BAL) fluid cultures in 292 trauma patients and had a sensitivity of 84% and a specificity of 69% [15]. More recently, the Clinical Pulmonary Infection Score (CPIS) was proposed by Pugin et al. [16], based on six variables (fever, leukocytosis, tracheal aspirates, oxygenation, radiographic infiltrates, and semi-quantitative cultures of tracheal aspirates with Gram stain) [16]. The original description showed a sensitivity of 93% and specificity of 100%, but this study included only 28 patients and the CPIS was compared to quantitative culture of BAL fluid using a 'bacterial index ' defined as the sum of the logarithm of all bacterial species recovered, which is not considered an acceptable gold standard for the diagnosis of VAP. Compared to pathological diagnosis, CPIS had a moderate performance with a sensitivity between 72 and 77% and specificity between 42 and 85% [11,17]. Likewise, CPIS was not sufficiently accurate compared to a BAL fluid-established

Pneumonia is an illness of the lower respiratory tract in which the lungs become inflamed and congested and alveolar spaces are filled with fluid and cells-polymorphs and lymphocytes (Mandell L.A). It is an inflammatory condition of the lung and it is one of the most serious infections, causing two million deaths annually among the young and elderly. Pneumonia is the largest killer, accounting for 28% to 34% of all child deaths below five years of age in low-income countries and is an important cause of mortality in the elderly in high-income countries (Suárez).

The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are